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MAGE-1, GAGE-1/-2 gene expression in FNAB of classic variant of papillary thyroid carcinoma and papillary hyperplasia in nodular goiter.

Differentiation of the papillary variant of papillary thyroid carcinoma (PTC) from papillary hyperplasia in nodular goiter may be difficult in fine-needle aspiration biopsy (FNAB) by means of morphology alone. To improve cytodiagnostic accuracy the occurrence of MAGE-1, GAGE-1/-2 gene expression was analyzed by means of RT-PCR. The genes investigated are recognized by autologous T lymphocytes and are expressed in carcinomas of various sites e.g. lung, ovary, colon but not in non-neoplastic tissue except testis. Routinely obtained smears with cytologic diagnosis of PTC confirmed by histology (n=20) and diagnosis of nodular goiter (n=10) were investigated. The MAGE-1, GAGE-1/-2 PCR products were found in 6/20 of the carcinomas but in none of the benign lesions. To identify PCR products automatic gene-sequencing in all positive cases was performed. The data indicate that MAGE-1, GAGE-1/-2 gene expression may give additional information to delineate PTC from papillary hyperplasia in FNAB.

Antigens, Neoplasm↗

Studies on T and B lymphocytes by the technique of immune and non-immune rosettes and by scanning electron microscopy (SEM) in Graves' disease and nontoxic nodular goiter.

T and B lymphocytes were studied by the rosettes technique (R) and scanning electron microscopy (SEM). Both techniques showed pathogenic changes in Graves' disease and nontoxic nodular goiter patients. In normal subjects, the mean value for T lymphocytes was 63.8% by R and 62.9% by SEM and for B lymphocytes was 39.9% by R and 29.8% by SEM. In Graves' disease the mean value of T lymphocytes was 93.1% by R and 92.8% by SEM whereas B lymphocytes represented 6.6% by R and 11.5% by SEM. In nontoxic nodular goiter, the mean T lymphocytes count was 64.5% by R and 61.5% by SEM, whereas B lymphocytes represented 27.9% by R and 29% by SEM. The increase in T lymphocytes number in Graves' disease confirms the role of cell immunity in its pathogeny unlike nontoxic nodular goiter where this mechanism has not been confirmed.

Adult↗

Serum thyroglobulin level in patients with diffuse and nodular goiter, after therapeutic application of stable iodine.

This study analysed the changes in serum thyroglobulin levels in euthyroid female patients, suffering from diffuse and scintigraphically functional nodular goiter, after therapeutic administration of two preparations of stable iodine: dried bovine thyroid, containing 100 mcg of iodine in one dragee (Thyral, Yugoslav Pharmacopea) and synthetic Na-salt L-thyroxine (Vobenol, with 100 mcg of iodine, too), for relatively short time of following-up, 8 weeks only. Having in mind the key role of TSH in regulation, all aspects of thyroid gland function, the interrelationship between TSH and thyroglobulin concentrations in those patients were also investigated. Prior to the therapy females had elevated thyroglobulin serum concentrations, caused by existence of diffuse and nodular goiter, which reflected an increase in intraglandular turnover of thyroglobulin (192 +/- 140 mcg/L in GROUP A further treated with Thyral and 121 +/- 14.80 +/- mcg/L in GROUP B, whose patients received Vobenol, mean +/- SD). Positive linear correlation between TSH and Tg levels was not established before therapy. Our data indicate that administration of two different preparations containing stable iodine in doses of 100 mcg every second day, during a two months period, resulted in significant decrease in the size of diffuse and nodular goiter, with diminished complains in a great number of patients. In thyroid humoral status, significant decrease of thyroglobulin concentrations was evident in both analysed groups (62 +/- 48 mcg/L, and 60 +/- 66, respectively). Presented results confirmed positive linear correlation between TSH and thyroglobulin in serum samples, after therapy, especially strong in the group treated with dried bovine thyroid.

Adult↗

[Nodular goiter recurrent after surgery. A study of its pathogenesis and incidence].

We analyzed 33 patients with recurring nodular goiter (from a population of 2,500 operated patients). Recurrence occurred 0.7 to 12 years after surgery. T4, T3, TSH, perchlorate and TRH tests were performed in 18. Results were similar to those in 13 operated patients without recurrence. Administration of thyroid hormone did not influence recurrence. Seven patients with recurring goiter were re-operated on; an encapsulated follicular cancer was found in one. Our results suggest that recurrence of nodular goiter after surgery is not prevented by routine use of thyroid hormone.

Adenoma↗

Risk factors for recurrent nodular goiter after thyroidectomy for benign disease: case-control study of 244 patients.

Surgery for recurrent nodular goiter is associated with a significant risk of parathyroid and recurrent laryngeal nerve (RLN) morbidity. Total thyroidectomy for benign disease is assessed. The aim of this study was to evaluate the risk factors for recurrence and the morbidity associated with reoperation. From 1969 to 1996 a total of 4334 thyroidectomies were performed, of which 122 were for recurrent nodular goiter (group I: 116 women, 6 men). A matched case-control study of 122 patients operated on for nonrecurrent multinodular goiter was performed (group II: 112 women, 10 men). Age, family history, initial surgery, pathology, and morbidity were compared in the two groups by chi2 test, Fisher's exact test, and the Mantel-Haenszel test. The mean age was 39.88 years in group I and 47.89 years in group II. There was no statistical difference in relation to the extent of thyroidectomy or morbidity after initial surgery. Statistical differences were identified regarding age (p = 0.000002) and the multinodular nature of the initial goiter (p = 0.005). Bilaterality and family history were less significant (p = 0.09 andp = 0.08, respectively). Temporary RLN palsy and temporary hypoparathyroidism were higher in group I (12.3% vs. 5.7%,p = 0.0737; 10.6% vs. 1.7%, p = 0.00337). Permanent RLN palsy was found in 0.8% in group I and in none in group II (p = 0.5, NS). Young age and multiple nodules at initial surgery are risk factors for recurrence. A higher rate of temporary morbidity was demonstrated after surgery for recurrent goiter. Total thyroidectomy for multinodular goiter is advisable.

Adolescent↗

[The structural-functional status of the thyroid in patients with nodular goiter evacuated from the 30-kilometer zone of the Chernobyl Atomic Electric Power Station].

An analysis was performed of results of ultrasonic and hormonal investigations in 239 patients with nodular goiter revealed in a screening-type clinical and laboratory examination of the 3371 persons evacuated from the 30-km zone of ChNPP, at their ages randing between 18 to 68 years. In 84.20% of patients in the group who took part in the elimination of effects of the Chernobyl accident (PEEA)--"PEEA + the evacuated"--the diameter of the nodules did not exceed 1 cm, in 6.1% it ranged from 1 to 2 cm, and in 13.41% it exceeded 2 cm. Distribution of nodules in the group "the evacuated" did not differ much from that in the above group. In 20% of patients with nodular goiter, there were functional disturbances concurrent with the autoimmune processes. No effects were detected of small doses of extra irradiation on the pattern of structural-and-functional indices in patients with nodular goiter evacuated from the 30-km zone of ChNPP who took part in EEA.

Adolescent↗